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A question for Dr. Watson

February 24, 2013 at 6:56 pm

Austin Frakt

I have little doubt Watson could be usefully applied in the field of medicine, which is not to say it will reduce spending. One thing it could do is more accurately prune the vast hypothesis tree that must be traversed between a patient’s first encounter and his diagnosis and treatment. Humans do this reasonably well, using heuristics, but still with many errors, as Jon Cohn reports.

Drawing on his own clinical experience and on academic studies, Kohn explained that about one-third of these errors appear to be products of misdiagnosis, one cause of which is “anchoring bias”: human beings’ tendency to rely too heavily on a single piece of information. This happens all the time in doctors’ offices, clinics, and emergency rooms. A physician hears about two or three symptoms, seizes on a diagnosis consistent with those, and subconsciously discounts evidence that points to something else. Or a physician hits upon the right diagnosis, but fails to realize that it’s incomplete, and ends up treating just one condition when the patient is, in fact, suffering from several. Tools like Watson are less prone to those failings. As such, Kohn believes, they may eventually become as ubiquitous in doctors’ offices as the stethoscope.

Cohn also notes that “Physicians, after all, do more than process data. They attend at patients’ bedsides and counsel families.” The act of just seeing a doctor can make patients feel better. Would the same be true of Dr. Watson? In other words, can Watson deliver a placebo effect?

We’ve been here before: the “expert systems” folks tried to do this back in the 1980s. I doubt Watson will do much better. You need someone to take responsibility for what goes wrong, and a computer program isn’t acceptabel in that role. So it’s never going to be more than a tool.

And I could write lots of nasty snark about AI types trying to play in fields where some of the respect and money is more likely to rub off on them…

“And do it for less pay”

While I respect MDs and don’t think they are the worst of the problem, if the US wants to see Japanese, or even European sorts of reasonable medical care costs, MD salaries will have to come down a bit.

I wish I could recall the name of an excellent book written by a family practitioner in the 1960’s or so, that discussed the propensity for “anchoring bias” and provided a canonical example from the physician’s early years of practice. A middle-aged woman presented with abdominal pains and while further detailing her symptoms, he interrupted her and declared that he know exactly the cause and proceeded to explain how her symptoms were related to a prolapsed uterus. As he was to subsequently learn, the woman had undergone a hysterectomy five years previously…